If I apply for MA using MNsure, how will it know I have a disability?

MNsure will check to see if you might qualify for disability-based MA if you answer "yes" to at least one of these questions when you fill out your MNsure application:

Are you blind or do you have a physical, mental, or emotional health condition that limits your activities (like bathing, dressing, daily chores, etc.)?

Do you need help staying in your home or help paying for care in a long-term care facility such as a nursing home?

Do you want help from Medical Assistance (MA) to pay for medical bills from the last three months?

MNsure will also check for disability-based MA eligibility if you say you're on Medicare.

If you have a disability and don't answer these questions correctly, you might not get the best health coverage for you. If you have any questions about applying, Chat with a Hub expert.

I have been getting MA because I have a disability. Will my MA change?

No. You can continue to get the Medical Assistance (MA) benefits you currently get.

Does it matter how I qualify for MA?

In most cases, no. The actual medical coverage you get from MA will basically be the same, no matter how you qualified. Generally speaking, the big difference is that people with disabilities have extra ways to qualify and if you have a disability and start working, you can earn more while still getting MA coverage.

What is “countable income?” Is it just how much I make?

No, it is not the same as how much you make. When many public programs look at your income to figure out if you should qualify, they don’t always count all of your income. What they do count is called “countable income.” This benefits you, because it means that you might have more income than the income limit for a program, but still qualify.

When your income is reviewed for disability-based Medical Assistance (MA), only about half of your earned income (money you get from work you do) is counted. For example, if you make $2,000 per month at a job and have no other income, that’s only $957.50 in countable monthly income.

Your Countable Income:

Your Monthly Earned Income

$

Your Monthly Unearned Income (not including SSI)

$

Your Monthly Impairment Related Work Expenses (IRWEs)

$

$1,012

$20

$65

$771

Your Monthly Countable Income

Your Annual Countable Income

$12,140

Federal Poverty Guideline

Your Countable Income as a Percent of FPG

Note: Countable income is used to see if you qualify for disability-based MA. If you do not have a disability, income-based MA will count all of your earned income. See DB101’s income-based MA article for more information.

To qualify for MA, is there a limit on the amount of assets my family can have?

It depends on how you qualified for Medical Assistance (MA). Income-based MA has no asset limit. However, some people with disabilities and seniors may qualify for disability-based MA or MA-EPD, which do have asset limits.

If you’re on SSI and MA and your monthly SSI cash benefit drops to zero because your earned income goes up, Social Security’s 1619(b) provision will let you keep your MA coverage, without having to pay a spenddown. Minnesotans with a disability on 1619(b) can have up to $53,658 in earned income and still keep their MA coverage as long as their assets don’t go above the SSI asset limit ($2,000 for an individual, $3,000 for a couple).

What is the difference between MA, MA with a spenddown, and MA-EPD?

MA: You only pay small copayments for medical services. You may qualify for income-based MA or disability-based MA, depending on your situation. You also qualify for MA if you qualify for SSI’s 1619(b) provision.

MA with a spenddown: You "spend down" your income by paying the first part of your medical costs. The amount you are responsible to pay before disability-based MA starts paying is the difference between your countable income and the "income standard." The income standard is 80% of the Federal Poverty Guidelines (FPG) ($810 for an individual, $1,098 for a family of two). Note: Usually, if you qualify, MA-EPD will be a better option than MA with a spenddown.

Medical Assistance for Employed Persons with Disabilities (MA-EPD): You pay small copayments and a monthly premium based on your income and household size. Generally, if you are certified disabled by the Social Security Administration or the State Medical Review Team (SMRT) and are working you will qualify for MA-EPD.

If my job offers me health coverage, am I allowed to sign up for MA?

Yes. If your family’s income is low enough for you to qualify for Medical Assistance (MA), you may do so even if your job offers insurance. If you are in this situation, you must tell your county human services agency about the insurance your employer offers. If your employer-sponsored plan is considered cost-effective, MA will pay your portion of the private plan’s monthly premium. If you have questions about this, Chat with a Hub expert.

I’m on Medicare. Why do I need MA?

Disability-based MA covers many services that Medicare doesn’t. If you have both MA and Medicare, you’ll have better health coverage. If you are eligible for Medicare Parts A and B, you have to keep them in order to enroll in MA. In most cases, MA will pay the Medicare premiums for you. With Medicare Part D, you’ll likely have cheaper prescription drug costs by enrolling in both programs.

Note: You usually cannot qualify for income-based MA if you get Medicare.

I’m an immigrant. Can I get MA?

Undocumented immigrants do not qualify for full Medical Assistance (MA) coverage, though in some cases they may qualify for MA coverage for emergencies.

Some noncitizens who have legal immigration status in the United States do not qualify for full MA coverage. However, if their income is below 200% of the Federal Poverty Guidelines (FPG), they may qualify for MinnesotaCare, a different public program.

Immigrants who have been legal residents for 5 years or longer and some other noncitizens with legal immigration status qualify for all of the same programs that citizens can get.

Note: If your earnings are over this limit and you have high medical expenses, you might still qualify for 1619(b). Ask your local Social Security office about the 1619(b) Individualized Earnings Threshold.

Monthly and annual income amounts used to determine financial eligibility for state and federal benefit programs.

Each year, the U.S. Department of Health and Human Services (HHS) issues the Federal Poverty Guidelines (FPG) in the Federal Register. The current FPG for one person is $12,490 per year; for two people, it's $16,910. Add $4,420 for each additional person.

Note: Different state and federal programs adopt the new Federal Poverty Guidelines on different dates each year.

Free MA covers all medically necessary health care services at no charge or for a small fee. If you meet eligibility requirements, including income limits, you will qualify for the program. If you qualify because of disability, asset limits may apply also.

If you get SSI, you will likely qualify for MA. You must apply for it separately though (you can't apply for it at Social Security).

If you have countable income that is greater than the income limit for disability-based Medical Assistance (MA), you may need to pay a spenddown to get MA coverage. A spenddown is the amount of money you have to pay for health care expenses each month before MA starts to pay for the rest of your health care bills.

You do not have to pay the full spenddown amount if your medical bills are less than the spenddown in any month. If, however, your monthly medical bills average less than your spenddown amount for several months, you will likely lose eligibility for the program at your next six-month review.

Once you have paid your spenddown amount, you won't have to pay any more for health care received in that month.